Preprocedural CT or MRI is useful for identifying anatomical variations like a common inferior PV trunk to guide safe and effective catheter ablation in patients with paroxysmal atrial fibrillation.
Preprocedural CT/MRI may aid ablation planning in rare PV variants; single-case data leaves generalizability open.
Herein we report a case of a patient presenting with paroxysmal atrial fibrillation (PAF) in whom the pulmonary veins (PVs) had a common inferior trunk and PV isolation at the common inferior trunk was successfully performed to prevent recurrence of PAR A 58-year-old man with drug-resistant PAF was referred to undergo curative treatment at our institution. A three-dimensional image of the PVs re-constructed by contrast-enhanced multi-detector computed tomography before the operation revealed a common inferior trunk of the PVs (24mm diameter). Segmental ostial PV isolation with the guidance of a circular mapping catheter was performed for both superior PVs and the common inferior PV trunk. All three PV ostia were successfully isolated from the LA, and the patient has been free from PAF thereafter for 18 months. Preprocedural multi-detector computed tomography or magnetic resonance imaging to evaluate the anatomy of PVs (the number, size, and shape) is thus considered to be useful for performing safe and smooth catheter ablation in patients with PAR
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Miyanaga et al. (2006) studied this question.
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